The practice of avoiding carbapenems in patients with β-lactam allergy should be abandoned considering the very low rate of cross-reactivity. β-Lactam-allergic patients who need ertapenem therapy should undergo skin tests and, if negative, a graded challenge to assess tolerability.

Using flow cytometry, food allergen-specific basophil responses could be monitored in order to identify an acquired tolerance induced by desensitization treatment. Although further studies are needed to develop this important new topic, it was interesting to note that the BAT seemed to be more sensitive and characterized by a close correlation with clinical tolerance.

No abstract

IntroductionLipid transfer proteins (LTP), profilin and PR-10 are the most important panallergens in central and southern Italy. Lipid transfer proteins are stable molecules, predominantly present in the fruit peel, which can induce systemic symptoms after ingestion of vegetables. Profilin and PR-10 are randomly distributed in the pulp and peel. Both are labile proteins and usually determine reactions restricted to the oral cavity. Panallergens-specific IgE may cross-react with homologues from different plant sources, due to their conserved structure.AimTo assess the pattern of sensitization to panallergens and the correlation with the clinical history and the allergological evaluation of food and aeroallergens.Material and methodsOne hundred and twenty patients with adverse reactions after vegetables ingestion underwent skin prick tests (SPT) with commercial extracts of plant-derived foods and inhalant allergens and commercial extracts of LTP, profilin and PR-10.ResultsMany patients presented positive SPT with different plant-food allergens. We found that 76 patients were sensitized to LTP, 14 to profilin and 5 to PR-10. In the LTP-sensitized group, 64 (84%) patients suffered from systemic symptoms while the patients sensitized only to profilin referred the oral allergy syndrome.ConclusionsThis study shows a high rate of sensitization to LTP in our population according to the literature about food allergy in our geographical area and confirms the literature data about the symptoms referred by patients with sensitization to panallergens. Panallergens should be considered as clinically relevant food allergens.

Objective: We present the case of a woman with 'empty sella syndrome' who experienced generalized urticaria after the administration of sodium succinate hydrocortisone in two episodes. Methods: The patient underwent an allergological evaluation (prick, intradermal, and patch tests) with hydrocortisone sodium succinate, hydrocortisone acetate, hydrocortisone, hydrocortisone sodium phosphate, methylprednisolone hemisuccinate, methylprednisolone, and preservatives held in the formulation of sodium succinate hydrocortisone (sodium phosphate and methyl-p-oxybenzoate). The basophil activation test (BAT) was also performed with hydrocortisone. The single-blind i.m. challenge test was performed with hydrocortisone sodium phosphate in 4 days. Results: Skin test with hydrocortisone sodium succinate and methylprednisolone hemisuccinate was positive. On the contrary, allergological tests performed with other formulations of the same steroids and preservatives were negative. These results showed an immediate-type allergy to succinate ester. BAT was not helpful to improve our diagnostic work-up because our patient was a 'nonresponder.' Therefore, the patient underwent successfully to a challenge test with hydrocortisone sodium phosphate. Conclusions: Patients with succinate ester allergy can tolerate alternative corticosteroids without ester.